Assessing Renal Function Flashcards Preview

Small Animal Internal Medicine > Assessing Renal Function > Flashcards

Flashcards in Assessing Renal Function Deck (38):
1

What are 4 causes of increased blood urea nitrogen?

1. Post-prandial

2. Dehydration

3. GI bleeding

4. Catabolic drugs

2

What are 3 causes of decreased blood urea nitrogen?

1. Malnutrition

2. Severe burns

3. Hepatic dysfunction

3

Creatinine increases with __1__ and __2__.

1. Muscle mass

2. High protein diet

4

In which 2 breeds are creatinine levels naturally high?

1. Birmans

2. Greyhounds

5

Which is more accurate, BUN or creatinine?

Creatinine

6

What does SDMA stand for?

Symmetric dimethylarginine

7

When can SDMA detect renal dysfunction?

At 40% loss of function

8

Which of the following is influenced by muscle mass: creatinine, BUN, or SDMA?

Creatinine

9

When does renal azotemic develop?

With 75% loss of function

10

What are the 4 substances used for clearance assays to measure GFR?

1. Inulin

2. Iohexol

3. Creatinine

4. Radioisotopes

11

What is the easiest and most commonly used substance for clearance assays?

Iohexol

12

What are 4 indications for using a clearance assay?

1. Identifying occult renal failure prior to starting nephrotoxic drugs

2. Assessing renal function in non-azotemic PU/PD patients

3. Screening patients with familial history of kidney disease

4. Investigating discrepancies in BUN and creatinine

13

What is one benefit to renal scintigraphy?

Ability to measure each individual kidney's GFR

14

What are the disadvantages of renal scintigraphy?

1. Expensive

2. Special facilities

3. Limited availability

15

What are the sources of proteinuria?

1. Physiological - fever, seizures, intense physical activity

2. Non-urinary - genital tract inflammation (vaginitis, prostatitis), hyperglobulinemia (multiple myeloma), hemoglobinemia (hemolytic anemia)

3. Urinary - glomerular disease, uroliths, UTIs, bladder tumors

16

The glomerulus allows passage of molecules less than ___-___ kDa

67-70 kDa

17

Resorption of most molecules (glucose, amino acids, HCO3, electrolytes) occurs where within the nephron?

Proximal tubule

18

What are 2 causes of renal proteinuria?

1. Increased loss of glomeruli

2. Decreased reabsorption in tubules

19

A dip stick can be used to quantify protein loss but primarily detects what?

Albumin

20

Which has more protein loss: (+) protein with USG 1.040 or (+) protein with USG 1.008?

(+) protein with USG 1.008

21

What is a normal urine protein/creatinine ratio in the dog?

< 0.5

22

What is a normal urine protein/creatinine ratio in the cat?

< 0.4

23

What are the 3 main roles of the renal tubules?

1. Water conservation

2. Acid/base balance

3. Reabsorption of metabolites

24

What is the renal tubular reabsorption threshold for glucose in the cat?

290 mg/dL

25

What is the renal tubular reabsorption threshold for glucose in the dog?

180-220 mg/dL

26

On average, the kidneys filter about ____ litters of water/day.

100 L

27

Of that 100 litters, less than ___% is lost to the urine.

1%

28

What is the specific gravity a ratio of?

Ratio of the weight of urine vs. weight of an equal amount of water

29

What is the isosthenuric range of urine?

1.008 - 1.012

30

At what concentration is urine equal to the osmolality of plasma?

1.008 - 1.012

31

What do you call urine with a USG of < 1.008?

Hyposthenuric

32

What are 4 drugs that cause the urine to be dilute?

1. Steroids

2. Diuretics

3. Colloids

4. Anti-epileptics

33

What are 4 concurrent diseases that might affect the USG?

1. Dehydration

2. Endocrine diseases (DM, cushing's, addison's)

3. Electrolyte abnormalities (hypercalcemia)

4. Infections (pyometra, pyelonephritis, leptospirosis)

34

What 3 things does one need to concentrate their urine?

1. ADH

2. ADH receptors

3. Functional kidneys

35

After running a water deprivation test and getting dilute urine, what is your next step?

Administer DDAVP (synthetic ADH)

36

If you get a response with synthetic ADH, what is your diagnosis?

Central DI

37

If you do not get a response with synthetic ADH, what is your diagnosis?

Nephrogenic DI

38

Because the water deprivation test is no longer recommended by most internists anymore, what is an alternative to test water conservation of the renal tubules?

Vasopressin test